Article Sidebar
Views PDF: 51
Effect of protective lung ventilation during cardiopulmonary bypass on serum procalcitonin and interleukin- 6 concentrations in coronary artery bypass grafting patients
Main Article Content
Abstract
Objective: Evaluation of changes in serum Interleukin-6 and pro-calcitonin levels in patients who underwent coronary artery bypass grafting with and without protective lung ventilation during cardiopulmonary bypass.
Methods: Randomised controlled trial. Eighty patients subjected to coronary bypass surgery were prospectively randomised to two groups: protective lung ventilation and no ventilation, during cardiopulmonary bypass. Serum interleukins - 6 levels were studied before and at6 hours, 24 hours, 48 hours and 72 hoursafter the cardiac surgery. Similarly, we also have measured serum procalcitonin (PCT) concentrations before and 24 hours after surgery.
Results: The serum levels of Interleukin 6 (IL-6) increased with time, peaked six hours after cardiac surgery and levels were higher in the non-ventilated group when compared with the protective lung ventilation group at 6 hours (362,09 ± 91.52 vs 306,16 ± 73.99 ; p<0.05) and 24 hours (256,5 ± 100,64 vs 204, 44 ± 52.59 ) after coronary artery bypass graft (CABG) operation. In addition, the secretion of pro-calcitonin after 24 hours surgery was significanly reduced in the ventilated patients compared to no ventilation patients (1.858 ± 4,205vs 4,302 ± 10,68; p< 0.05).
Conclusion: The protective mechanical ventilation during cardiopulmonary bypass may decrease serum IL-6 and procalcitonin concentrations after CABG.
Article Details
Keywords
Lung protective ventilation, cardiopulmonary bypass, coronary artery bypass grafting, Interleukin 6, pro- calcitonin
References
2. Zhang WR, Garg AX, Coca SG, et al. Plasma IL-6 and IL-10 Concentrations Predict AKI and Long-Term Mortality in Adults after Cardiac Surgery. J Am Soc Nephrol. 2015;26(12):3123-3132. doi:10.1681/ASN.2014080764
3. Sponholz C, Sakr Y, Reinhart K, Brunkhorst F. Diagnostic value and prognostic implications of serum procalcitonin after cardiac surgery: a systematic review of the literature. Crit Care. 2006;10(5):R145. doi:10.1186/cc5067
4. Gagnon J, Laporta D, Béïque F, Langlois Y, Morin JF. Clinical relevance of ventilation during cardiopulmonary bypass in the prevention of postoperative lung dysfunction. Perfusion. 2010;25(4):205-210. doi:10.1177/0267659110373839
5. Maintaining Ventilation During Cardiopulmonary Bypass Attenuates Polymorphonuclear Cell Activation and May Reduce Pulmonary Polymorphonuclear Cell Sequestration - Ng - 2002 - Journal of Cardiac Surgery - Wiley Online Library. Accessed May 31, 2023. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1540-8191.2002.101435.x
6. Bignami E, Saglietti F, Di Lullo A. Mechanical ventilation management during cardiothoracic surgery: an open challenge. Ann Transl Med. 2018;6(19):380. doi:10.21037/atm.2018.06.08
7. Wrigge H, Uhlig U, Baumgarten G, et al. Mechanical ventilation strategies and inflammatory responses to cardiac surgery: a prospective randomized clinical trial. Intensive Care Med. 2005;31(10):1379-1387. doi:10.1007/s00134-005-2767-1
8. Mechanical Ventilation During Cardiopulmonary Bypass - PubMed. Accessed May 31, 2023. https://pubmed.ncbi.nlm.nih.gov/27468893/
9. Ng CSH, Arifi AA, Wan S, et al. Ventilation during cardiopulmonary bypass: impact on cytokine response and cardiopulmonary function. Ann Thorac Surg. 2008;85(1):154-162. doi:10.1016/j.athoracsur.2007.07.068
10. Beer L, Szerafin T, Mitterbauer A, et al. Continued mechanical ventilation during coronary artery bypass graft operation attenuates the systemic immune response. European Journal of Cardio-Thoracic Surgery. 2013;44(2):282-287. doi:10.1093/ejcts/ezs659
11. Durukan AB, Gurbuz HA, Salman N, Unal EU, Ucar HI, Yorgancioglu CEM. Ventilation during cardiopulmonary bypass did not attenuate inflammatory response or affect postoperative outcomes. Cardiovasc J Afr. 2013;24(6):224-230. doi:10.5830/CVJA-2013-041
12. Ai AL, Hall D, Bolling SF. Interleukin-6 and Hospital Length of Stay after Open-heart Surgery. Biol Psichiatr Psichofarmakol. 2012;14(2):79-82.
13. de Oliveira CMB, Sakata RK, Issy AM, Gerola LR, Salomão R. Cytokines and pain. Rev Bras Anestesiol. 2011;61(2):255-259, 260-265, 137-142. doi:10.1016/S0034-7094(11)70029-0
14. Branislav S. Changes in Interleukin-6 and Highly Sensitive C-Reactive Protein in Patients who Underwent Redo Coronary Artery Bypass Grafting. J Clin Exp Cardiolog. Published online 2013. doi:10.4172/2155-9880.S7-003
15. Kallel S, Abid M, Jarraya A, et al. [Kinetics, diagnostic and prognostic value of procalcitonin after cardiac surgery]. Ann Biol Clin (Paris). 2012;70(5):567-580. doi:10.1684/abc.2012.0745
16. Klingele M, Bomberg H, Schuster S, Schäfers HJ, Groesdonk HV. Prognostic value of procalcitonin in patients after elective cardiac surgery: a prospective cohort study. Ann Intensive Care. 2016;6(1):116. doi:10.1186/s13613-016-0215-8
17. Procalcitonin and C-Reactive Protein as a Specific Marker of Sepsis in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass. IJSR. 2017;6(7):2199-2202. doi:10.21275/ART20175676
18. Loebe M, Locziewski S, Brunkhorst FM, Harke C, Hetzer R. Procalcitonin in patients undergoing cardiopulmonary bypass in open heart surgery-first results of the Procalcitonin in Heart Surgery study (ProHearts). Intensive Care Med. 2000;26 Suppl 2:S193-198. doi:10.1007/BF02900737
19. Hirose H. Procalcitonin guided antibiotic management for the post-operative open heart surgery patient with clinical suspicion of sepsis. In: ; 2014.
20. JIAO J, WANG M, ZHANG J, SHEN K, LIAO X, ZHOU X. Procalcitonin as a diagnostic marker of ventilator-associated pneumonia in cardiac surgery patients. Exp Ther Med. 2015;9(3):1051-1057. doi:10.3892/etm.2015.2175.
Similar Articles
- Dao Quang Vinh, Nguyen Sinh Hien, Ta Hoang Tuan, Comments of results after surgical replacement of mechanical mitral and aortic valve in children at Hanoi Heart Hospital , The Vietnam Journal of Cardiovascular and Thoracic Surgery: Vol. 35: SỐ ĐẶC BIỆT KỶ NIỆM 20 NĂM THÀNH LẬP BỆNH VIỆN TIM HÀ NỘI
- Pham Viet Hung, Trinh Van Manh, Nguyen Huy Tien, Nguyen Thi Thoa, Ngo Van Tuan, Nguyen Huu Uoc, Phung Duy Hong Son, Vu Ngoc Tu, Early results of heart valve replacement surgery at Quang Ninh Provincial General Hospital , The Vietnam Journal of Cardiovascular and Thoracic Surgery: Vol. 34
- Nguyen Tran Thuy, Dam Hai Son, Nguyen Cong Huu, Surgery results of Cox-Maze IV procedure in treatment for atrial fibrillation combined with valve disease at Cardiovascular Center, E hospital , The Vietnam Journal of Cardiovascular and Thoracic Surgery: Vol. 39
- Hoang Dinh Nguyen, Ngoc Minh Vuong, Xuan Dinh Bui, Ngoc Hai Dang Nguyen, Tran Viet Chuong Pham, Duc An Vinh Bui, Early and mid-term outcomes of minimally invasive mitral valve surgery in high operative risk patients at University Medical Center, Ho Chi Minh City , The Vietnam Journal of Cardiovascular and Thoracic Surgery: Vol. 46
- Pham Huu Lu, Nguyen Huu Uoc, Mitral valve replacement with full – sternotomy through a minimal skin incisions , The Vietnam Journal of Cardiovascular and Thoracic Surgery: Vol. 3
- Duong Duc Hung, Pham Quoc Dat, Vuong Hai Ha, Duong Thi Hoan, Le Duc Thang, Nguyen Duc Nha, Pham Thai Son, Evaluation of results of minimally invasive cardiac surgery with video assisted in Bach Mai hospital3 , The Vietnam Journal of Cardiovascular and Thoracic Surgery: Vol. 18
- Quang Vinh Dao, Sinh Hien Nguyen, Hoang Tuan Ta, Surgical results of heart valve disease because of bacteriological endocarditis in children at hanoi heart hospital , The Vietnam Journal of Cardiovascular and Thoracic Surgery: Vol. 43: SỐ ĐẶC BIỆT CỦA HỘI TIM MẠCH THÀNH PHỐ HÀ NỘI
- Van Hung Dung, Hoang Anh Khoi, Nguyen Thi Nhu Ha, Nguyen Tien Hao, Outcomes of heart valve surgery during pregnancy , The Vietnam Journal of Cardiovascular and Thoracic Surgery: Vol. 34
You may also start an advanced similarity search for this article.